Tai Chi Improves Balance in Patients with Parkinson’s

Parkinson’s disease is a progressive neurologic disorder. Parkinson’s biggest initial impact is on how patients move. Patients have tremors and have difficulty initiating movement. They walk with short shuffling steps. Balance worsens and falls are common. Parkinson’s disease is treated with medications and rarely with brain surgery. Resistance-based exercise has been shown to slow the worsening of balance and strength in patients with Parkinson’s disease, but these exercises frequently require equipment and supervision.

Tai chi is an ancient Chinese martial art. Its emphasis on slow graceful movements, balance, and attention to breathing has made it a very popular form of exercise and meditation. Researchers thought that it would be a good way to improve balance in Parkinson’s patients. A study published in this week’s New England Journal of Medicine shows they were right.

The study enrolled 195 ambulatory Parkinson’s patients to three groups. Each group attended a sixty minute exercise class twice a week for six months. One group attended tai chi classes. A second group attended resistance-based strength training classes. A third group (the control group) did stretching.

All patients had objective measures of their balance and gait and kept a log of any falls. They were followed for three months after the end of their exercise classes.

As expected, the tai chi and strength training groups had better test results than the stretching group in measures of walking and strength. But he patients who did tai chi had better balance than the other two groups and also had fewer falls. The benefits persisted even three months after the end of the classes. And there were no serious adverse effects, which would be unheard of in a trial of a medication or surgery.

This reveals an appealing opportunity for Parkinson’s patients – exercises that require no equipment, can be learned and then practiced at home without assistance, and are relatively inexpensive. Though there is no evidence generalizing this finding to other causes of balance disorder, like strokes or Alzheimer’s disease, tai chi seems to me to be a very reasonable and harmless intervention in these disorders too.